Benefily
No prior authorization

Does Medco Containment Life And Medco Containment Ny require prior authorization for Unithroid?

Medco Containment Life And Medco Containment Ny does not require prior authorization for Unithroid on the Medicare Part D plans that cover it.

No covering plan from this payer files a prior-authorization requirement for this drug.

  • This drug does not appear on any of this payer's Medicare Part D formularies. That means it is NOT COVERED under those plans — which is a different and generally worse outcome than requiring prior authorization. An exception or formulary-exception request may still be possible.

By product strength

RxNorm productPlans coveringRequire prior authStep therapyQty limitStatus
levothyroxine sodium 0.025 MG Oral Tablet [Unithroid]96622860 / 60000No prior authorization
levothyroxine sodium 0.088 MG Oral Tablet [Unithroid]96623260 / 60000No prior authorization
levothyroxine sodium 0.1 MG Oral Tablet [Unithroid]96623360 / 60000No prior authorization
levothyroxine sodium 0.112 MG Oral Tablet [Unithroid]96623560 / 60000No prior authorization
levothyroxine sodium 0.125 MG Oral Tablet [Unithroid]96623760 / 60000No prior authorization
levothyroxine sodium 0.15 MG Oral Tablet [Unithroid]9662380 / 60000Not on formulary
levothyroxine sodium 0.2 MG Oral Tablet [Unithroid]9662410 / 60000Not on formulary
levothyroxine sodium 0.3 MG Oral Tablet [Unithroid]9662430 / 60000Not on formulary
levothyroxine sodium 0.05 MG Oral Tablet [Unithroid]9662440 / 60000Not on formulary
levothyroxine sodium 0.175 MG Oral Tablet [Unithroid]9662460 / 60000Not on formulary
levothyroxine sodium 0.075 MG Oral Tablet [Unithroid]9662860 / 60000Not on formulary
levothyroxine sodium 0.137 MG Oral Tablet [Unithroid]9664360 / 60000Not on formulary

Product names come from RxNorm (U.S. National Library of Medicine).

Plan-by-plan detail — levothyroxine sodium 0.025 MG Oral Tablet [Unithroid]

Unithroid has 12 products in the corpus; this table is for levothyroxine sodium 0.025 MG Oral Tablet [Unithroid], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
HealthSpring Assurance Rx (PDP)S5617-0034NoNoNo
HealthSpring Assurance Rx (PDP)S5617-0084NoNoNo
HealthSpring Assurance Rx (PDP)S5617-0134NoNoNo
HealthSpring Assurance Rx (PDP)S5617-0184NoNoNo
HealthSpring Assurance Rx (PDP)S5617-0684NoNoNo
HealthSpring Assurance Rx (PDP)S5617-0884NoNoNo
HealthSpring Assurance Rx (PDP)S5617-1034NoNoNo
HealthSpring Assurance Rx (PDP)S5617-1084NoNoNo
HealthSpring Assurance Rx (PDP)S5617-1134NoNoNo
HealthSpring Assurance Rx (PDP)S5617-1184NoNoNo
HealthSpring Assurance Rx (PDP)S5617-1234NoNoNo
HealthSpring Assurance Rx (PDP)S5617-1284NoNoNo
HealthSpring Assurance Rx (PDP)S5617-1334NoNoNo
HealthSpring Assurance Rx (PDP)S5617-1384NoNoNo
HealthSpring Assurance Rx (PDP)S5617-1434NoNoNo
HealthSpring Assurance Rx (PDP)S5617-1484NoNoNo
HealthSpring Assurance Rx (PDP)S5617-1534NoNoNo
HealthSpring Assurance Rx (PDP)S5617-1584NoNoNo
HealthSpring Assurance Rx (PDP)S5617-2144NoNoNo
HealthSpring Assurance Rx (PDP)S5617-2154NoNoNo
HealthSpring Assurance Rx (PDP)S5617-2164NoNoNo
HealthSpring Assurance Rx (PDP)S5617-2174NoNoNo
HealthSpring Assurance Rx (PDP)S5617-2184NoNoNo
HealthSpring Assurance Rx (PDP)S5617-2194NoNoNo
HealthSpring Assurance Rx (PDP)S5617-2204NoNoNo
HealthSpring Assurance Rx (PDP)S5617-2214NoNoNo
HealthSpring Assurance Rx (PDP)S5617-2224NoNoNo
HealthSpring Assurance Rx (PDP)S5617-2234NoNoNo
HealthSpring Assurance Rx (PDP)S5617-2244NoNoNo
HealthSpring Assurance Rx (PDP)S5617-2254NoNoNo
HealthSpring Assurance Rx (PDP)S5617-2264NoNoNo
HealthSpring Assurance Rx (PDP)S5617-2274NoNoNo
HealthSpring Assurance Rx (PDP)S5617-3484NoNoNo
HealthSpring Extra Rx (PDP)S5617-3533NoNoNo
HealthSpring Extra Rx (PDP)S5617-3543NoNoNo
HealthSpring Extra Rx (PDP)S5617-3553NoNoNo
HealthSpring Extra Rx (PDP)S5617-3563NoNoNo
HealthSpring Extra Rx (PDP)S5617-3583NoNoNo
HealthSpring Extra Rx (PDP)S5617-3593NoNoNo
HealthSpring Extra Rx (PDP)S5617-3603NoNoNo
HealthSpring Extra Rx (PDP)S5617-3623NoNoNo
HealthSpring Extra Rx (PDP)S5617-3633NoNoNo
HealthSpring Extra Rx (PDP)S5617-3643NoNoNo
HealthSpring Extra Rx (PDP)S5617-3653NoNoNo
HealthSpring Extra Rx (PDP)S5617-3663NoNoNo
HealthSpring Extra Rx (PDP)S5617-3673NoNoNo
HealthSpring Extra Rx (PDP)S5617-3683NoNoNo
HealthSpring Extra Rx (PDP)S5617-3693NoNoNo
HealthSpring Extra Rx (PDP)S5617-3703NoNoNo
HealthSpring Extra Rx (PDP)S5617-3713NoNoNo
HealthSpring Extra Rx (PDP)S5617-3723NoNoNo
HealthSpring Extra Rx (PDP)S5617-3733NoNoNo
HealthSpring Extra Rx (PDP)S5617-3753NoNoNo
HealthSpring Extra Rx (PDP)S5617-3773NoNoNo
HealthSpring Extra Rx (PDP)S5617-3783NoNoNo
HealthSpring Extra Rx (PDP)S5617-3793NoNoNo
HealthSpring Extra Rx (PDP)S5617-3803NoNoNo
HealthSpring Extra Rx (PDP)S5617-3813NoNoNo
HealthSpring Extra Rx (PDP)S5617-3823NoNoNo
HealthSpring Extra Rx (PDP)S5617-3853NoNoNo
Source
Monthly Prescription Drug Plan Formulary and Pharmacy Network Information — Basic Drugs Formulary File
Effective
2026-06-30
Retrieved
2026-07-19
SHA-256
e626e6bcda1aa6a0071e6f0df6bafe686ae41842cdf0a9feffdc649b6d3ff3ae

We publish the hash of the exact file we ingested so any answer can be audited against the bytes CMS served that day.

Unithroid at other payers

Or see Unithroid across every payer at once.

Administrative information only. Benefily reports what a payer has published in its own prior-authorization policy as of the effective date shown. It is not medical advice, not a coverage or payment guarantee, and not an authorization. Requirements vary by plan, place of service and member benefits — always verify with the payer before rendering service.